DOCSLIB.ORG

3GIRS) Product in Combination with Long-Lasting Insecticidal Nets in Zambezia, Mozambique

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
3GIRS) Product in Combination with Long-Lasting Insecticidal Nets in Zambezia, Mozambique A cluster randomized trial to measure the impact of indoor residual spraying with a third-generation indoor LB-5532 residual spray (3GIRS) product in combination with long-lasting insecticidal nets in Zambezia, Mozambique Carlos Chaccour1,2, Joe Wagman3, Christelle Gogue3, Kenzie Tynuv3, Sergi Alonso1,2, Rose Zulliger4, Amilcar Nacima2, Eldo Elobolobo2, Binete Savaio5, Abuchahama Saifodine4, Baltazar Candrinho6, Hidayat Kassim7, Christen Fornadel8, Aklilu Seyoum9, Kenyssony Varela10, Jason Richardson11, Laurence Slutsker3, Molly Robertson3*, Francisco Saute2 1 ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona; 2 Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; 3 PATH, Washington DC, USA; 4 President’s Malaria Initiative and Division of Parasitic Diseases and Malaria, US Centers for Disease Control and Prevention, Maputo, Mozambique; 5 PATH, Mopeia Sede, Mozambique; 6 Programa Nacional do Controlo da Malaria (NMCP), Mozambique;7Direcção Provincial de Saúde Zambézia, Quelimane, Mozambique; 8US President's Malaria Initiative, US Agency for International Development, Washington, DC, USA; 9Abt Associates, Bethesda, MD USA; 10Abt Associates, PMI-AIRS Mozambique; 11IVCC, Liverpool, UK Introduction Interim Results The Mopeia District of Zambezia Province in Mozambique has a high malaria burden despite documented high long-lasting insecticide-treated nets (LLIN) access. Entomological Surveillance Active Cohort Surveillance In this context, a two-year, two-armed cluster-randomized trial is ongoing to determine the impact of indoor residual spray (IRS) when combined with LLINs. One study arm is receiving standard LLINs only and the Active Case Detection: Preliminary summary based on other is receiving IRS with a microencapsulated formulation of pirimiphos-methyl (Actellic®300CS) in Monthly trends in total An. funestus specimens collected addition to LLINs. in CDCLTs, by IRS status. spray status only The epidemiological and entomological impact and cost-effectiveness of adding IRS to LLINs are being 17-month cumulative rate ratio: 0.81 (0.77 – 0.84) evaluated over two years through active case detection in a cohort of 1548 children followed monthly, Considering the months January – June, IRS was associated with a Crude Protective Efficacy: 19.4% enhanced passive surveillance, two annual cross-sectional surveys, continuous entomological sizable cumulative reduction in An. funestus densities: Cohort Infections Prevented: 1,105 surveillance, and prospective monitoring of intervention and malaria-associated costs. 63% reduction in 2017 (year 1) Total Infections Prevented (all IRS clusters): 16,235 85% reduction in 2018 (year 2) Here, preliminary interim results comparing a key surveillance indicators from the LLIN and LLIN+IRS study arms are presented. Study Location Cross-Sectional Surveys Passive Health Facility Surveillance 2017 2018 No Spray​ Spray OR No Spray​ Spray OR = al ages RDT+​ (overall) 191 (42.5%)​ 164 (44.4%)​ 1.08 173(42.6%) 131 (34.1%) 0.70* = u5 Passive Case Detection: Preliminary summary based on RDT+ (u5) 86 (47.3%) 96 (52.7%) 1.16 122 (63.2%) 92 (47.2%) 0.52* spray status only 1 Possess nets 255 (56.9%) 184 (49.9%) - 356 (94.1%) 374 (95.2%) - 2 Used nets 66% 59% - 75% 83% - 17-month cumulative rate ratio: 0.75 (0.73 – 0.87) Crude Protective Efficacy: 25% 1 From the cross-sectional survey question: does this household have at least 1 LLIN? u5 cases averted at health facilities: 4,806 2 From the active cohort household visit survey question: did the cohort member sleep under an LLIN last night? Total u5 cases Prevented (all IRS clusters): 6,920 * Odds Ratio (OR) is significantly different than 1.0, p<0.001 Mopeia District Clusters established at the village level • 7, 614 km2 • Clusters stratified by number of households • 160,000 total population (Large (>125), Med (71 - 125), Small (<70)) Discussion • 30,000 children under 5 years old (U5) • Randomized 1:1 to receive IRS (Spray) or No-IRS • U5 malaria prevalence = 54% (2012) (No spray) with Actellic in 2016 and 2017. All clusters to receive SumiShield in 2018 (see timeline) • 1 District Hospital and 13 local Health Facilities • Preliminary analysis of interim results from this cluster randomized trial show that case data from routine health • >50% of households own at least 1 LLIN in systems reflect the same trends seen in infection data from the active cohort – a significant reduction in malaria 2015 incidence of approximately 20% to 25% in IRS vs. non-IRS clusters An. funestus s.l., the dominant vector species in Mopeia, demonstrated resistance (<90% mortality in WHO tube tests) to pyrethroids and bendiocarb in 2018 • The effect has persisted for two years but health facility routine data suggests that the impact on case reduction may be amplified in year two after a universal LLIN distribution campaign in mid 2017 Study Timeline Entomological Surveillance Passive Case Detection • Similarly, cross sectional survey data showed no impact of IRS 5 months after the first spray campaign, but indicates Active Cohort Visits a significant reduction in malaria infection prevalence in year two (5 months after the second spray campaign) Cross Sectional Surveys J FMAM J J A S ON D J FMAM J J A S ON D J FMAM J J A S ON D J FMAM J J A S ON D 2016 2017 2018 2019 • Results are also supported by reductions in vector abundance and biting rates in IRS clusters vs. non-IRS clusters Actellic IRS Universal LLIN Actellic IRS SumiShield IRS (43 IRS clusters only) Distribution (43 IRS clusters only) (All 86 clusters) • Final, in-depth analyses are forthcoming and will aim to understand the incremental benefit of IRS on top of LLINs in a The study is expected to continue for a 3rd year after the decision to spray SumiShield® 50WG (clothianidin) in all villages in Mopeia high prevalence setting. Formal analysis will utilize models to account for the effects of clustering, stratification, and in 2018. The study team will continue entomological collections, passive case detection, and will perform a 3rd parasite prevalence random effects. survey to determine the effects of this rotation strategy on previously sprayed (Actellic) clusters as well as spray naïve clusters. Project Partners *The NgenIRS (Next Generation IRS) project is a partnership, led by IVCC, that includes the US President’s Malaria Initiative, Abt Associates, and PATH. NgenIRS works in close References collaboration with leading insecticide manufacturers, national malaria control programs, 1Chaccour, et al. 2018. BMJ Glob Health;3(1):e000610 the Global Fund, and other stakeholders to save lives and protect health by reducing transmission of malaria through affordable indoor residual spraying of long lasting, non- pyrethroid insecticides. It is funded by UNITAID. For more information please visit http://www.ivcc.com/ngenirs or email David McGuire ([email protected])..
Load more

Recommended publications
  • Malawi ALMA Quarterly Report, September 2011
    Malawi ALMA Quarterly Report Quarter Three, 2020 Scorecard for Accountability and Action Key Malaria is endemic in all parts of Malawi. The annual reported number of malaria cases in 2018 was 5,865,476 with 2,967 deaths. Target achieved or on track Progress but more effort required Not on track No data Not applicable Malawi ALMA Quarterly Report Quarter Three, 2020 Malaria Sustaining Essential Health Services During the COVID-19 Pandemic The COVID-19 pandemic is putting an incredible strain on health systems across Africa. Health systems are required to maintain routine health services for other illnesses even as they handle the additional burden. In order to prevent widespread morbidity and mortality, it is of vital importance that we work to sustain the delivery of essential life- saving interventions during this difficult time including for Reproductive, Maternal, Newborn, Adolescent and Child health and malaria. WHO underlines the critical importance of sustaining efforts to prevent, detect and treat malaria during the COVID-19 pandemic. It is of vital importance to ensure the continuity of malaria prevention and treatment services including distribution of insecticide-treated nets and indoor residual spraying, as well as chemoprevention for pregnant women (intermittent preventive treatment in pregnancy). Any intervention must consider the importance of both lowering malaria-related mortality and ensuring the safety of communities and health workers given the ease of transmission of COVID-19. For Malawi, it will be of vital importance to ensure that the planning for the universal coverage campaign for long-lasting insecticidal nets (LLINs) campaign scheduled for 2021 and the indoor residual spraying campaign go ahead, whilst taking into account physical distancing, in accordance with the recent guidance and recommendations from WHO and the RBM Partnership to End Malaria.
    [Show full text]
  • Community Knowledge and Acceptance Of
    Magaço et al. Malar J (2019) 18:27 https://doi.org/10.1186/s12936-019-2653-x Malaria Journal RESEARCH Open Access Community knowledge and acceptance of indoor residual spraying for malaria prevention in Mozambique: a qualitative study Amílcar Magaço1*, Carlos Botão1, Pedroso Nhassengo1, Mohomede Saide1, Arminda Ubisse1, Sérgio Chicumbe1 and Rose Zulliger2 Abstract Background: Malaria control remains a leading health challenge in Mozambique. Indoor residual spraying (IRS) is an efective strategy to control malaria transmission, but there are often barriers to reaching the coverage necessary for attaining maximum community protective efect of IRS. Mozambique recorded a high number of household refusals during the 2016 IRS campaign. This study sought to evaluate household and community factors related to the accept- ability of IRS to inform strategies for future campaigns in Mozambique and the region. Methods: A cross-sectional, qualitative study was conducted in eight urban and rural communities in two high malaria burden provinces in Mozambique. Data were collected through in-depth interviews with community mem- bers, leaders, sprayers, and representatives of district health directorates; focus group discussions with community members who accepted and who refused IRS during the 2016 campaign; systematic feld observations; and informal conversations. Data were systematically coded and analysed using NVIVO-11®. Results: A total of 61 interviews and 12 discussions were conducted. Community participants predominantly described IRS as safe, but many felt that it had limited efcacy. The main factors that participants mentioned as having infuenced their IRS acceptance or refusal were: understanding of IRS; community leader level of support; characteristics of IRS programmatic implementation; environmental, political and historical factors.
    [Show full text]
  • Toolkit for the Sound Management of Ddt for Disease Vector Control
    Stockholm Convention on Persistent Organic Pollutants (POPs) Scientific and Technical Document Series: DDT TOOLKIT FOR THE SOUND MANAGEMENT OF DDT FOR DISEASE VECTOR CONTROL Acknowledgements The Secretariat of the Stockholm Convention (SSC) acknowledges the collaboration and support extended by the Global Malaria Programme of the World Health Organization and its Africa and South-East Asia regional offices for technical inputs in the development of this document. Contributions by delegates representing national malaria control programmes and national focal points of the Stockholm Convention from Botswana, Cambodia, China, Congo DRC, Comoros, Eritrea, Ethiopia, Ghana, India, Indonesia, Kenya, Malaysia, Mauritius, Morocco, Mozambique, Namibia, Nepal, Papua New Guinea, Senegal, South Africa, Sri Lanka, Swaziland, Vietnam and Zambia, and those from academia and non- governmental organizations are gratefully acknowledged. The Secretariat acknowledges the collaboration and support in organizing the workshops provided by Jiangsu Institute of Parasitic Diseases (JIPD), Wuxi, Jiangsu province, China, The Basel Convention Regional Centre for Asia and the Pacific/Stockholm Convention Regional Centre for Capacity-building and the Transfer of Technology in Asia and the Pacific, China and the Stockholm Convention Regional Center, Kenya. The financial support of Government of France on this work is gratefully acknowledged. The views expressed herein can in no way be taken to reflect the official opinion of France. 2 Copyright @ Secretariat of the Stockholm Convention (SSC), January 2016 This publication may be reproduced in whole or in part and in any form for educational or non-profit purposes without special permission from the copyright holder, i.e. SSC, provided acknowledgement of the source is made. SSC would appreciate receiving a copy of any publication that uses this publication as a source.
    [Show full text]
  • An Observational Analysis of the Impact of Indoor Residual Spraying
    Wagman et al. Malar J (2018) 17:19 https://doi.org/10.1186/s12936-017-2168-2 Malaria Journal RESEARCH Open Access An observational analysis of the impact of indoor residual spraying with non‑pyrethroid insecticides on the incidence of malaria in Ségou Region, Mali: 2012–2015 Joseph Wagman1*, Christelle Gogue1, Kenzie Tynuv1, Jules Mihigo2, Elie Bankineza3, Mamadou Bah3, Diadier Diallo4, Andrew Saibu5, Jason H. Richardson6, Diakalkia Kone7, Seydou Fomba7, Jef Bernson8, Richard Steketee9, Laurence Slutsker9 and Molly Robertson1 Abstract Background: Ségou Region in Central Mali is an area of high malaria burden with seasonal transmission, high access to and use of long-lasting insecticidal nets (LLINs), and resistance to pyrethroids and DDT well documented in Anoph- eles gambiae s.l. (the principal vector of malaria in Mali). Ségou has recently received indoor residual spraying (IRS) sup- ported by Mali’s collaboration with the US President’s Malaria Initiative/Africa Indoor Residual Spraying programme. From 2012 to 2015, two diferent non-pyrethroid insecticides: bendiocarb in 2012 and 2013 and pirimiphos-methyl in 2014 and 2015, were used for IRS in two districts. This report summarizes the results of observational analyses carried out to assess the impact of these IRS campaigns on malaria incidence rates reported through local and district health systems before and after spraying. Methods: A series of retrospective time series analyses were performed on 1,382,202 rapid diagnostic test-confrmed cases of malaria reported by district routine health systems in Ségou Region from January 2012 to January 2016. Malaria testing, treatment, surveillance and reporting activities remained consistent across districts and years dur- ing the study period, as did LLIN access and use estimates as well as An.
    [Show full text]
  • The Impact of Indoor Residual Spraying (IRS) on Malaria Prevalence Between 2001 and 2009 in Mpumalanga Province, South Africa
    The impact of indoor residual spraying (IRS) on malaria prevalence between 2001 and 2009 in Mpumalanga province, South Africa By LINDOKUHLE M. NGOMANE A dissertation submitted in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE IN EPIDEMIOLOGY in the School of Health Systems and Public Health Faculty of Health Sciences UNIVERSITY OF PRETORIA SUPERVISOR: PROF C. DE JAGER January 2012 © University of Pretoria © University of Pretoria ACKNOWLEDGEMENTS I would like to thank my supervisor, Prof Christiaan de Jager for his valuable and professional guidance and support as well as continuous motivation throughout this project. A special thank you to the Mpumalanga Department of Health: Malaria Control Programme for providing me with malaria data and support with additional relevant documents. I also thank the South African Weather Service for assisting me with climate data. This study would not have been possible without these Departments’ assistance with data provided in a timely manner. I thank Dr Steve Olorunju of the Medical Research Council (MRC) for his assistance with the statistical analysis and interpretation of the data. I am grateful to Mandla Zwane from Mpumalanga Department of Health for his comments and suggestions as well as support and encouragement during this project. Lastly, I thank my family, friends and colleagues for their patience, continued encouragement and support. L.M. Ngomane University of Pretoria, 2012 i DECLARATION I declare that the dissertation, which I hereby submit for the degree Master of Science (MSc) in Epidemiology at the University of Pretoria, is my own work and has not previously been submitted by me for a degree at this or any other tertiary institution.
    [Show full text]
  • RE-INTRODUCTION of INDOOR RESIDUAL SPRAYING INTO PACIFIC ISLANDS Background and Current Status
    RE-INTRODUCTION OF INDOOR RESIDUAL SPRAYING INTO PACIFIC ISLANDS Background and current status Dr Tessa Knox WHO Vanuatu Country Liaison Office APMEN Tech Talks - 30 September 2020 1 Background: Solomon Islands including targeted IRS 1/10/2020 2 Source: Adapted from - Solomon Islands Strategic Plan for Malaria Control and Elimination, 2012-2025 Background: Papua New Guinea 1/10/2020 3 Source: Papua New Guinea National Malaria Strategic Plan, 2012-2025 Background: Vanuatu Deaths, cases by parasite species, and annual parasite incidence (API) (2000-19) Tropical Cyclone Pam Source: National Malaria and Other Vector Borne Diseases Control Program Similarities across three Pacific countries • Ongoing persistent malaria transmission in some areas (An. farauti) • High vulnerability to natural disasters and outbreaks • High rural population and severe logistical challenges • Issues with LLIN access, usage or efficacy • Additional measures required to accelerate progress towards malaria elimination • IRS used successfully in the past though no empirical evidence • New tools (insecticide formulations, spray machines) give opportunity to increase spray quality and efficacy • Additional funding through GF (regular allocation, MEMTI and PAAR) • Recent Malaria Program Reviews and new Malaria Strategic Plans present renewed opportunity to emphasise importance of IRS Status: New strategic plans SOLOMON ISLANDS PAPUA NEW GUINEA VANUATU LLINs (mass + continuous) LLINs (mass + continuous) LLINs (mass + continuous) IRS in outbreak areas IRS in high burden/low LLIN use Responsive IRS in outbreaks (non-pyrethroid) areas (non-pyrethroid) and foci (non-pyrethroid) Alternative tools + personal Supplementary tools + personal Alternative tools + personal protection (high-risk, high- protection (high-risk, high- protection (high-risk, high- exposure populations) exposure populations) exposure populations) 6 Focal responsive (outbreaks, foci) Status: progress and plans • Drive is to re-commenced IRS in all three countries by 2021 • Additional resources identified (eg.
    [Show full text]
  • Indoor Residual Spraying for Preventing Malaria (Review)
    Indoor residual spraying for preventing malaria (Review) Pluess B, Tanser FC, Lengeler C, Sharp BL This is a reprint of a Cochrane review, prepared and maintained by The Cochrane Collaboration and published in The Cochrane Library 2010, Issue 4 http://www.thecochranelibrary.com Indoor residual spraying for preventing malaria (Review) Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. TABLE OF CONTENTS HEADER....................................... 1 ABSTRACT ...................................... 1 PLAINLANGUAGESUMMARY . 2 BACKGROUND .................................... 2 OBJECTIVES ..................................... 4 METHODS ...................................... 4 RESULTS....................................... 7 Figure1. ..................................... 10 Figure2. ..................................... 11 DISCUSSION ..................................... 18 AUTHORS’CONCLUSIONS . 19 ACKNOWLEDGEMENTS . 19 REFERENCES ..................................... 20 CHARACTERISTICSOFSTUDIES . 27 DATAANDANALYSES. 45 HISTORY....................................... 45 CONTRIBUTIONSOFAUTHORS . 45 DECLARATIONSOFINTEREST . 45 SOURCESOFSUPPORT . 45 DIFFERENCES BETWEEN PROTOCOL AND REVIEW . .... 45 Indoor residual spraying for preventing malaria (Review) i Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. [Intervention Review] Indoor residual spraying for preventing malaria Bianca Pluess1, Frank C Tanser2, Christian Lengeler1, Brian L Sharp3 1Public Health and Epidemiology, Swiss Tropical
    [Show full text]
  • Evaluating the Additive Effect of an Indoor Residual Spraying Campaign
    Evaluating the additive effect of an indoor residual spraying campaign for reducing the burden of malaria in an Eritrean low-transmission setting Impact Evaluation Concept Note IRS Impact Evaluation: Eritrea: version 05.14.09 1 Table of Contents A. Background ........................................................................................................................ 3 B. Project Goal ........................................................................................................................ 3 C. Research Design and Methods ........................................................................................... 4 C.1. Study Site Description ..................................................................................................... 5 C.2. Intervention and Control Arm Description ..................................................................... 5 C.3. Evaluation Plan ............................................................................................................... 6 C.4. Study Outcomes and Indicators....................................................................................... 6 C.5. Sampling Design ............................................................................................................. 7 C.6. Sample Size and Power Calculations .............................................................................. 8 C.7. Data Collection Activities ............................................................................................... 8 C.7.1 Entomological
    [Show full text]
  • Is Indoor Residual Spraying Broken and What Should Be Fixed?
    SL-1 Is Indoor Residual Spraying broken and what should be fixed? Hindrik Bouwman*1, Henrik Kylin1,2, Riana Bornman3 1Research Unit: Environmental Sciences and Management, North-West University, South Africa 2Department of Thematic Studies, Linkoping University, Sweden 3University of Pretoria Centre for Sustainable Malaria Control, and School of Health Systems and Public Health, University of Pretoria, South Africa Indoor residual spraying (IRS) has been and is still a very successful method to control malaria. We are concerned that not enough research attention is given to improving IRS and that most funding goes towards modern but seemingly still ineffectual methods. We believe that there is ample scope for improving IRS, while reducing insecticide exposure Keywords: Indoor residual spray, IRS, Botha de Meillon, policy 1. Introduction Indiscriminate use and use in agriculture may have The effectiveness of DDT and other insecticides led to resistance in many areas. Combining basic when properly used as indoor residual spray (IRS) biological knowledge about reproductive behaviour to prevent the transmission of malaria is not in of the female vector mosquito with residual question [1] (Fig 1). We can safely assume that toxic chemicals within and close to residential millions of lives have been saved in the more than areas where most infections occur, is effective at 80 years since it was first used [1]. The high body preventing transmission, but bad at preventing burden of DDT of those protected by IRS, as well as chemical exposure and uptake of the chemicals by the human health consequences of those protected residents - posing a paradox. by all IRS insecticides are of great concern [1,2].
    [Show full text]
  • 2. Effect of Indoor Residual Spraying on the Incidence of Malaria
    Medical Journal of Zambia, Vol. 42, No. 4: 150-158 (2015) ORIGINAL ARTICLE Effect of Indoor Residual Spraying on the Incidence of Malaria in Kaoma District of Western Zambia E Phiri1,2, KS Baboo2, J Miller3 *1Ministry of Health, Provincial Medical Office, Western Province, 2 Department of Public Health, School of Medicine, University of Zambia, 3Malaria Control & Evaluation Partnership in Africa (MACEPA), National Malaria Control Centre, Lusaka, Zambia ABSTRACT (PPS) was used to select clusters in which respondents were picked. To validate the findings of Background: Indoor residual spraying (IRS), the the study, statistical significance was set at p < 0.05. application of a chemical to the internal walls of the structure in order to kill an insect that sits on the wall Results: The study demonstrated that areas with a treated with such a chemical, is one of the methods larger percentage of the population (greater than adopted by World Health Organisation in combating 60%) protected by Indoor residual spraying had malaria by controlling the vector mosquito. In line lower incidence of malaria (82/1000 and 400/1000) with the Zambian policy on malaria control Kaoma compared to unsprayed area (398/1000 and district in Western province of Zambia in 2008, 773/1000) both at the beginning and pick of malaria started implementing IRS as the method of transmission season. A chi-square test shows that combating malaria. The main purpose of the study there was an association between spraying and was to ascertain the effect of indoor residual reduced malaria incidence, p <0.05. Factors such as spraying on incidence of malaria in Kaoma district length of Insecticide Treated Nets ownership and of Western Province of Zambia.
    [Show full text]
  • Download Here
    FALL 2020 Contents Selected Recent Publications ...................................................................................................................................................... 4 Cytochrome P450-based metabolic insecticide resistance in Anopheles and Aedes mosquito vectors: Muddying the waters ...................................................................................................................................................................................... 4 Decreased bioefficacy of long-lasting insecticidal nets and the resurgence of malaria in Papua New Guinea ...................... 4 Efficacy of Royal Guard, a new alpha-cypermethrin and pyriproxyfen treated mosquito net, against pyrethroid-resistant malaria vectors......................................................................................................................................................................... 5 After those nets are torn, most people use them for other purposes”: an examination of alternative bed net use in western Kenya.......................................................................................................................................................................... 5 Semi-field evaluation of freestanding transfluthrin passive emanators and the BG sentinel trap as a “push-pull control strategy” against Aedes aegypti mosquitoes .......................................................................................................................... 5 Evaluating Over-the-Counter Household
    [Show full text]
  • Indoor Residual Spraying: an Operational Manual (Second Edition)
    INDOOR RESIDUAL SPRAYING AN OPERATIONAL MANUAL FOR INDOOR RESIDUAL SPRAYING (IRS) FOR MALARIA TRANSMISSION CONTROL AND ELIMINATION SECOND EDITION Indoor Residual Spraying AN OPERATIONAL MANUAL FOR INDOOR RESIDUAL SPRAYING (IRS) FOR MALARIA TRANSMISSION CONTROL AND ELIMINATION SECOND EDITION WHO Library Cataloguing-in-Publication Data Indoor residual spraying: an operational manual for indoor residual spraying (IRS) for malaria transmission control and elimination – 2nd ed. 1.Malaria – prevention and control. 2.Insecticides – administration and dosage. 3.Mosquito Control – methods. 4.Handbooks. I.World Health Organization. ISBN 978 92 4 150894 0 (NLM classification: WC 765) © World Health Organization 2015 All rights reserved. Publications of the World Health Organization are available on the WHO website (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications –whether for sale or for non-commercial distribution– should be addressed to WHO Press through the WHO website (www.who.int/about/licensing/copyright_ form/en/index.html). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned.
    [Show full text]